Laser Iridotomy for Glaucoma

Surgery Overview

Laser iridotomy uses a very focused beam of
light to create a hole on the outer edge, or rim, of the iris, the colored part
of the eye. This opening allows fluid (aqueous humor) to
flow between the anterior chamber, the front part of the eye, and the area
behind the iris, the posterior chamber. This opening may decrease pressure in
the eye and usually prevents sudden buildup of pressure within the eye, which
occurs during an episode of acute closed-angle glaucoma.

Some
people feel a mild but sharp sensation in the eye during this procedure. But there
usually is no pain after laser iridotomy.

What To Expect After Surgery

Laser iridotomy can be done without
admitting the person to a hospital. The person may need to see his or her
doctor 1 hour after laser surgery. The person will also need to see the doctor
for a follow-up exam as recommended.

Why It Is Done

Laser iridotomy is mainly used to:

Treat
closed-angle glaucoma after the pressure in the
affected eye has been reduced with medicine or when medicines
fail.

Prevent closed-angle glaucoma in people who have narrow
drainage angles and those people who have had
closed-angle glaucoma in their other eye.

How Well It Works

Laser iridotomy
can usually prevent slow-forming (subacute) closed-angle glaucoma in people who
are at risk for closed-angle glaucoma.

Sometimes people can take
less medicine to treat glaucoma after having laser iridotomy.

Risks

Complications of laser iridotomy may
include:

Brief blurred vision
(common).

Swelling of the clear covering (cornea) of the
iris.

Bleeding.

Increased pressure in the
eye.

Later complications may include:

Further clouding of the lens (cataract)
compared to what was present before laser treatment.

Closure of the opening.

Recurrent closed-angle glaucoma.

Development of
another type of glaucoma.

Continuing need for medicines (depends on
the person's condition before laser treatment).

Glare or double vision from light
entering through the new opening.

What To Think About

Closed-angle glaucoma usually
affects both eyes over time. When sudden (acute) closed-angle glaucoma occurs
in one eye and laser surgery has been done on that eye, laser iridotomy is
usually done on the other eye to prevent the condition from developing. Without
treatment, there is a 50% chance that closed-angle glaucoma will also develop
in the unaffected eye.1

High pressure in the eyes may continue after laser iridotomy. The person may
need to be watched closely for this even after the procedure. Some people may
need additional treatment, such as eyedrops or surgical iridectomy, to lower the eye
pressure.

American Academy of Ophthalmology (2010). Primary Angle Closure (Preferred Practice Pattern). San Francisco: American Academy of Ophthalmology. Also available online: http://aao.org/ppp.

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